Re: Planning the consultant workforce in oral & maxillofacial surgery.
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A recent conference of the California Society of Pediatric Dentists discussed issues surrounding the shortage of pediatric dentists in the state. Several contributing factors were identified and recommendations made regarding ways of working with the dental schools to help increase the number of practitioners. This article frames the problem regarding servicing the state's children and discusses some recommended actions.
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The number of current practitioners, academicians, and researchers in Pediatric Dentistry is clearly not adequate to meet the need and demand. The shortage in academia is dire. Simply put, not enough pediatric dentists are being trained. The rate limiting factor is the number of training positions. The American Academy of Pediatric Dentistry established a "Task Force on Work Force Issues" approximately 18 months ago and charged that group to seek methods for creating more training positions. This paper reflects the Task Force deliberations, documents the shortage of pediatric dental specialists, and recommends tactics for amelioration.
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The UK is very reliant on physiotherapists who trained overseas, who now represent almost a third of new entrants. Australia is the main source of overseas-trained physiotherapists. It the UK is to increase recruitment of physiotherapists from overseas, ethical considerations mean it should focus on the EU, the US and Australasia and not developing countries.
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The current system of medical manpower planning fails to balance doctors' training requirements with the demands of the NHS. Urgent action is needed to avoid a manpower crisis. Specialist registrars regularly have to leave their hospitals for training sessions, forcing the cancellation of sessional work. Hospital medicine is relying heavily on locums and doctors from abroad. Consultants should be given the junior support they need in order to provide a proper service, possibly through increasing the time spent at senior house officer level.
A review of the workings of the medical unit in a district general hospital concluded a radical change in roles would be needed over the next 10 years. The role of healthcare assistants, nursing and therapy assistants and auxiliaries will need to be enhanced to take on more of the unit's work in future. The review proposed the creation of a healthcare practitioner role, covering much of the current workload of junior doctors, nurses and therapists and extended responsibilities for diagnostic tests and their interpretation.
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AIM: To present the case for a primary health care (PHC) approach for dental care in Vietnam, and thereby contribute to a better understanding of the oral health problems that exist in many developing countries. METHODS: Information was obtained in Vietnam through discussions with dental and medical authorities of provincial health offices, educational institutions, hospitals, health centres and schools and by collecting data from record books and reports. FINDINGS: Dentistry lacks a PHC strategy and consequently urgent oral care and oral disease prevention and control are not available for the majority of the population in Vietnam. The curriculum of dental students and dental auxiliaries is not adequately directed to the oral health needs of the population. The present number of dental personnel is too low. CONCLUSION: A basic oral health care package (BOHCP) advocated by the WHO which could be incorporated into primary health services at sub-district level and in the school dental service would be most suitable to meet the oral health needs of the population in Vietnam. The oral health education component of the BOHCP may have more impact when it is conducted in close collaboration with non-dental health personnel and lay persons. The curriculum of dental personnel should be adjusted to meet the requirements of their future tasks. Dental auxiliaries, provided they are well trained can carry out the BOHCP. Consequently, there is a large need for this type of dental personnel in Vietnam.
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